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Biomedical subjects

K Perkins

Publications and source records attributed to K Perkins.

14 recordsLinked to original sources
PubMed1998

Case management for the baby boom generation: a strengths perspective.

To understand the challenges and opportunities for case management as the turn of the century approaches, we must consider the 76 million individuals born between 1946 and 1964, commonly referred to as the baby boom generation. This article examines the baby boom generation in the context of planning effective case management services. The generation's strengths are highlighted to suggest how case management systems can meet the anticipated service needs of baby boomers as they age.

Aged↗
PubMed1997

Endothelium-dependent relaxation is not uniformly impaired in chronic heart failure.

Abnormalities of vasomotor tone are characteristic of heart failure. This study was designed to assess the effects of chronic heart failure on endothelium-dependent relaxation in both large conduit arteries and small resistance vessels and to determine whether or not impaired nitric oxide (NO) production is involved. Segments of pulmonary artery (PA), abdominal aorta (AA), and small mesenteric artery (MA) were harvested from rats with heart failure resulting from coronary artery ligation and from sham-operated controls. Organ-bath experiments done in the presence of indomethacin to avoid the influence of vasodilatory prostanoids demonstrated that relaxation to acetylcholine (ACh) was impaired in the PA but not the AA or MA of the group with heart failure. Endothelium-independent relaxation to nitroglycerin was not significantly affected by the development of heart failure. Constriction to prostaglandin (PG) F(2alpha) was enhanced in PA but not in AA or MA segments. Preincubation with N(omega)-nitro-L-arginine (NNA) to inhibit the production of NO increased baseline force in vessels from all three beds, but the effect was greatest in the PA. Although relaxation to ACh was significantly diminished by NNA in the PA, it was not completely abolished. Furthermore, ACh-mediated relaxation in the presence of NAA was still impaired in the group with heart failure compared with the sham-operated control group. NNA had only mild effects on ACh-mediated relaxation in MA. These results demonstrate that (a) the mediators of endothelium-dependent relaxation may vary throughout the arterial circulation, (b) the contribution of NO to endothelium-dependent relaxation is substantial in PA and minimal in mesenteric resistance vessels, (c) endothelium-dependent relaxation is not uniformly impaired throughout the arterial bed by the development of heart failure, and (d) although a defect in NO production may account for enchanced vasoconstriction seen in response to PGF(2alpha), it does not account for the diminished vasodilatory response to ACh in this experimental model of heart failure.

Acetylcholine↗
PubMed1997

You won't know unless you ask: the biopsychosocial interview for adolescents.

In order to impact morbidity and mortality of adolescents, the health care provider must not only determine the risk status of the teenager but also take time to provide appropriate guidance and interventions. We have developed the West Virginia University Adolescent Risk Score, which is more inclusive than similar screening techniques and requires an 8 +/- 3-minute interview. This format facilitates specific guidance, provides documentation of risk status, and is readily accessible on future visits. Our data provide the basis for planning and research regarding the effectiveness of interventions.

Adolescent↗
PubMed1993

Chronic benzodiazepine administration. XI. Concurrent administration of PK11195 attenuates lorazepam discontinuation effects.

Benzodiazepine discontinuation is associated with alterations in motor activity and gamma-aminobutyric acid-A receptor upregulation in a mouse model. Prior studies indicate that concurrent administration of the compound N-methyl-N-(methyl-1-propyl)chloro-2-phenyl-1-isoquinoline-3- carboxamide (PK1195), a "peripheral" site benzodiazepine antagonist, can attenuate the effects of lorazepam on tolerance and receptor alterations. To evaluate the effects of PK11195 administration on benzodiazepine discontinuation, we administered lorazepam (2 mg/kg per day), PK 11195 (1 to 10 mg/kg per day) or the combination to mice for 7 days, and then evaluated pentylenetetrazole-induced seizure threshold and benzodiazepine binding at days 1, 4, and 7 after discontinuation. Seizure threshold was reduced at 4 days after lorazepam discontinuation; this effect was attenuated by coadministration of PK11195 at 5 mg/kg per day. Lorazepam discontinuation effects were not altered by PK11195 at 1 mg/kg per day, whereas the 10-mg/kg dose was not different from 5 mg/kg per day. The competitive ligand Ro5-4864 at 10 mg/kg per day, blocked the effects of PK11195 on lorazepam discontinuation. Benzodiazepine receptor binding in vivo was increased in the cortex and hippocampus at 4 days postlorazepam discontinuation. This effect was attenuated in the hippocampus but not in the cortex by concurrent administration of PK1195. These data indicate that concurrent administration of PK11195 may attenuate discontinuation effects of lorazepam.

Animals↗
PubMed1993

Case management. A comparative analysis of the United States and Great Britain.

With the pronounced growth in long-term care in the United States and Great Britain over the last two decades, there has been a quantitative move away from institutional care to community-based home care. This growth has pushed public funding and the delivery of social and health services in the two countries to the limits. This article presents a comparative analysis of the case management systems as they relate to long-term care in both countries. We also make recommendations to strengthen both countries' case management systems.

Health Planning↗
PubMed1992

Psychosocial implications of women and retirement.

This article explores the unique effects of retirement on women, many of whom are economically insecure when they retire. Because of the prevailing "myth" among women that they will be cared for in old age and women's fear of growing old, women often do not aggressively plan for their retirement. The women's movement should begin to advocate for women's preparation for the realities of old age.

Age Factors↗
PubMed1990

Specialty nursing council: a peer support group for nurses in independent roles.

As nurses move into more nontraditional, expanded roles, they sometimes lack a social and professional support group within the work setting. Feeling isolated and lacking support, several clinical nurse specialists (CNSs) at a large county institution began the Specialty Nursing Council. The Specialty Nursing Council provides a means of networking and support for nurses in specialty roles in a three institution health care campus. Monthly meetings are conducted to bring members together and for continuing education programs. The keys to success in forming this type of council are: 1) a dedicated group that plans, organizes, and distributes informational material; 2) common goals and objectives; 3) direct benefits to members.

Humans↗
PubMed1989

Smoking.

Explore the source record for details and available documents.

Forecasting↗
PubMed1987

Current materials and techniques used in a burn scar management programme.

A range of materials is now available for use in a burn scar management programme. The use of these materials is detailed and suggestions are made based upon the experience gained from close clinical observation of children treated over a 7-year period at the Adelaide Children's Hospital Burn Clinic. Lightweight pressure garments are still needed to keep these various media in contact but are not included in the discussion.

Bandages↗
PubMed1983

Silicone gel: a new treatment for burn scars and contractures.

A new method of treatment for burn scar management is outlined using silicone gel sheets (Spenco Corporation MD-3071). The method has been applied to 42 patients with burns of varying degree and maturity. The results have been successful in all cases. The mode of action of the gel is unknown, but it does not rely on pressure. The method can easily be tailored to the individual needs of the scar and the patient. Individual initiative and a flexible approach to its use are advocated.

Adolescent↗
PubMed1983

Physical diseases in schizophrenia and affective disorder.

Studies of the increased or decreased risk of specific physical diseases in patients with schizophrenia and affective disorder are reviewed. Existing data suggest further examination of the following relationships: (1) the presence in schizophrenics of increased incidence of gastrointestinal cancer and of cardiovascular and infectious diseases, and of decreased incidence of lung cancer and rheumatoid arthritis; and (2) the increased incidence of circulatory, respiratory, and atopic diseases, and of diabetes mellitus among patients with major affective disorder. A majority of the studies reviewed failed to meet methodologic standards necessary to provide conclusive evidence. An ongoing research project which generally meets these standards, the Oxford Record Linkage Study, is described.

Aged↗